Research Paper Title
Challenges with strengthening exercises for people with knee osteoarthritis and comorbid obesity: a qualitative study with patients and physiotherapists.
Explore challenges associated with implementing a home-based strengthening exercise programme for people with knee osteoarthritis and comorbid obesity.
Qualitative study embedded within a randomised controlled trial comparing two home-based strengthening programmes (weight bearing functional exercise versus non-weight bearing quadriceps strengthening exercise) for people with knee osteoarthritis and comorbid obesity.
Patients in both exercise programmes attended five consultations with a physiotherapist and undertook a home-based exercise programme for 12 weeks.
Semi-structured individual telephone interviews were conducted with 22 patients after trial completion, and all seven physiotherapists who delivered trial interventions.
Interviews were recorded, transcribed verbatim, and thematically analysed using an inductive approach.
Three themes arose:
- Psychological challenges (false assumptions about exercise; fear of pain; disliking exercise; mental effort of weight bearing functional programme; underestimating capability);
- Physical challenges (complexity of weight bearing functional programme; cuff weights and straight leg raise problematic in non-weight bearing quadriceps programme; other health conditions); and
- Overcoming challenges (incentives to exercise; accountability; education and reassurance; tailoring the exercise programme).
Patients and physiotherapists experienced numerous psychological and physical challenges to exercise, including a fear of pain, having false assumptions about exercise, difficulties with exercise performance, application of cuff weights, and adverse impacts of other health conditions.
Lawford, B.J., Bennell, K.L., Allison, K., Schwartz, S. & Hinman, R.S. (2020) Challenges with strengthening exercises for people with knee osteoarthritis and comorbid obesity: a qualitative study with patients and physiotherapists. Arthritis Care & Research (Hoboken). doi: 10.1002/acr.24439. Online ahead of print.